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41 Cards in this Set

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Clarifying Techniques
Techniques that help both participants identify major differences in their frame of reference. The purpose is to promote mutual understanding.
Nurse requests feedback re: accuracy of message received (verbal/nonverbal)
Clinical Interview
a systematic attempt to either
* understand those problems in clients’ lives that interfere with meeting their goals
*to help them improve their skills
*learn alternative ways of dealing effectively with their problem.
Closed Questions
Ask for specific information (dates, names, numbers, "yes" or “no” information).
Congruent Communication
Matching between verbal and nonverbal messages
Cultural Filters
A form of Cultural Bias or Predjudice that determines what we pay attention to and what we ignore
Intellectual process that involves understanding correctly another's emotional state and point of view; an appropriate emotional response by the provider.
A technique that enables the nurse to examine important ideas, experiences, or relationships more fully. "Everybody hates me"... "Give me an example"
The response or message that the receiver returns to the sender during communication.
AKA: response
4th component of communication process
Leading Question
A question that influences the client to give a particular answer; usually a closed question
E.g. "you will take your medicine won't you?"
The means (medium) by which a message can be sent.
E.g. through auditory (hearing), a visual (seeing), or a tactile (touch) means
Neutral questions
A question the client can answer without direction or pressure.
Open ended, and is used in nondirective interviews.
Example: “How do you feel about that?”
Open-Ended question
require more than a one-word answer (i.e. “yes” or “no”).
Can encourage lengthy information on experiences, perceptions or responses to a situation.
(i.e. “Tell me something about your family”.)
Restating in different (often fewer) words the basic content of a client’s message.
E.g., "In other words, you seem to be saying..."
Personal space
The distance people prefer in interactions with others.
Asking for information chiefly out of curiosity rather than with intent to assist the client.
Asking “why” can be probing and my place client in a defensive position.
Process Recording
Process recordings are written records of a segment from the nurse-client session that reflects as closely as possible the verbal and non-verbal behaviors of both client and nurse.
Reflecting is a means of assisting people to better understand their own thoughts and feelings.
Distilling of someone's message and identifying what may be their main priority.
Mirroring the client’s overt and covert messages.
Restating differs from paraphrasing. It involves repetition of the same key words the client has just spoken.
The study of words and their meanings
Why Questions
May imply criticism and make the person defensive.
It is much more useful to ask “what is happening” rather than “why it is happening.”
4 phases of the nurse-client therapuetic relationship (Pg. 433)
1. Pre-interaction: e.g. read file
2. Introductory: first meetings (sets tone for relationship)
3. Working (accomplish task outlined in earlier phase)
4. Termination
Ways the nurse can enhance the development of a therapuetic realtionship
Consistency (same nurse), Honesty, Genuiness, Empathy, Positive Regard;
Listening; Pacing (according to clients comfort level and ability); Good initial impressions; promote comfort and client control; trust and active participation.
Role of boundaries in the nurse-client relatiionship
Nurse must keep client needs and roles distinct from their own.
Discuss counter Transference and transference...
•Transference: Redirection of feelings to a substitute (nurse, therapist) things that one experienced originally as a child
* counter-transference: when the helping professional transfers their emotional baggage onto client.
Differentiate between verbal(content) and non-verbal(process) communications.
Verbal Communications: Consist of all words a person speaks.
Non-verbal Communications: Consist of the tone of voice, manner in which a person paces his/her speech, facial expression, body posture, amount of eye contact, eye cast (emotion expressed in the eyes), hand gestures, signs, fidgeting etc...
5 Elements of Berla's Communication Process
•Stimulus (cause or reason for communication) •Sender (initiates interpersonal contact. AKA source)•Message •Mediums (channels) •Receiver
Cultural Factors influencing the communication process
Communication style,
eye contact, perception of touch and cultural filters
Impaired verbal communication related to language barrier can manifest in:
Decreased, delayed or absent ability to receive, process, transmit and use a system of symbols-
• Anxiety
• Powerlessness
• Situational low self esteem
• Social isolation
• Impaired social interaction
Nursing strategies for the client with impaired verbal communication
•Manipulate the environment:
•Provide Support
•Employ measures to enhance communication
•Educate the client and support persons
11. Outcomes for the client with impaired verbal communication
•Begins to establish method of communication
•Uses verbal or nonverbal techniques to indicate needs.
•Perceives the message accurately, •Regains maximum communication abilities.
•Expresses minimum fear, anxiety, frustration and depression.
•Uses resources appropriately.
Techniques which facilitate effective theraputic communications
1.Use of Silence
2.Active Listening
3. Clarifying techniques
Techniques that obstruct effective theraputic communication
•Asking excessive questions: appears interogating, demanding, disrespectful
•Giving approval/disapproval: kind of like judging, cuts of communication
•Advising- rarely helpful: when asking for advice client is seeking confirmation of their own thinking
•“Why" questions
List possible goals for a clinical interview (Pg. 172 Vacarolis)
Specific goals may be:
•Identify and explore problems relating to others;
•Discuss healthy ways of meeting emotional needs;
•Experience a satisfying and interpersonal relationship; and
•Feel understood and comfortable.
Helpful Guidelines in conducting a clinical interview (Pg. 172,3 Vacarolis)
•Speak briefly
•When you don’t know what to say, say nothing
•When in doubt, focus on feelings
•Avoid advice
•Avoid relying on questions
•Pay attention to non-verbal clues
•Keep focus on the client
Aspects necessary in planning the interview and setting
Setting: Establish a setting that enhances feelings of security:
Offer introductions and provide overview of meeting;
Confidentiality issues are addressed;
Assume same height;
Angle instead of face to face positioning;
Use settings with a door- client between it and nurse. No barrier between self and door.
Stages of an interview (x3)
Pg. 268
Opening/Introduction: sets the tone, establish rapport
Body/development: Substance of meeting with full interaction from client
Closing: when information has been obtained, or when client declines to provide necessary infor, meeting is terminated
Good and bad aspects of using the Process Recording?
Good: Useful tool for identifying communication patterns
Bad: Rely on memory; subject to distortions
What are the two aspects of the Working Phase?
1. Exploring and understanding thoughts and feelings
2. Facilitating and taking actions
What are 2 common reasons that boundaries get blurred?
1. Relationship slips into a social context
2. Nurses needs are met at expense of clients
4. Actions that nurses may manifest when boundaries are blurred are (x3)
1. Overhelping
2. Controlling (for their own good)
3. Narcisism (the need to find weakness in others so that the nurses importance is magnified)
12. Examples of Active Listening
1. Observe client's non-verbal behaviors
2. Listening to and understanding verbal message
3. Understanding context of the person's social/cultural setting
4. Listen for 'false notes'.
5. Providing feedback that the client might not be aware of.